Dual AV Nodal Pathways—Vagal Influences on AV Nodal Conduction |
| |
Authors: | MARILYN D. EZRI SHOEI K. HUANG RAMESH CHHABLANI PABLO DENES |
| |
Affiliation: | Section of Cardiology, Department of Medicine, Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois |
| |
Abstract: | This 52-year-old male presented with syncope and demonstrated two distinct PR intervals on the electrocar-diogram. Electrophysiologic studies showed dual A V nodal path ways. Right-sided carotid sinus massage induced prolonged periods of sinus arrest with no change in AH interval. Left-sided carotid sinus massage produced long AH intervals (slow pathway conduction) with some slowing of sinus rate. Whenever sinus rhythm with slow pathway conduction was observed (long AH) a 20-30 mmHg drop systolic pressure was seen. Following implantation of an AV sequential pacemaker, the patient has been asymptomatic. |
| |
Keywords: | carotid sinus hypersensitivity carotid sinus massage |
|